Long term strategy & switch

[Spacey & Ella]

(Cross posting, isg vetsulin/caninsulin)

Hallo,

My cat Spacey is not very easy to regulate on caninsulin and therefore I'm wondering whether to push the vet to change it to Lantus/Levemir.
On the other hand: there is still an infection in her mouth.

So:
1) When is the right time to switch to another type of insulin? Before or after her tooth is removed (Jan, 13th)?
2) Do I have to pick a time when I'm able to home test a lot? (I work 4 day's a week, but I have a week vacation after Spacey's operation on her tooth f.i.)
3) How should I prepare? What to read besides the Lantus board??
4) Or shouldn't I switch at all and see how it goes in the month or so after the operation?

Every idea is greatly appreciated.

 

[Sweetgrass & the Furries]

Good to see you made it here Ella....

You are in good hands

 

[Greg and Carmelita (GA)]

1) When is the right time to switch to another type of insulin? Before or after her tooth is removed (Jan, 13th)?

I would say after--a dental can have a VERY dramatic impact on regulation, and if you change now, you might have a tougher time seeing what it post-dental and what is post-switch. Let the dental and recovery time happen, and then see about switching.

2) Do I have to pick a time when I'm able to home test a lot? (I work 4 day's a week, but I have a week vacation after Spacey's operation on her tooth f.i.)

Most folks who start low (very conservative, per Tilly dosing guidelines) don't really need a curve until the 3rd day on Lantus. It is probably a good idea to be there the entirely of the first cycle or two, in case there is some kind of reaction, but since that first dose is held a week at least, probably starting on the last day of your weekend, working 4 days, and doing a curve on the first day of the next weekend would be OK.

3) How should I prepare? What to read besides the Lantus board??

The Lantus board, a 2nd time! LOL. Seriously, though? Read the how-to stuff we have, especially the Tilly protocol. Re-read the handling, and read as many 'condos' as you can stand--see how it goes for other members. Read profiles, look at spread sheets, see if we are using any weird terminology you want to know. Read old hands, newbies, and even OTJ folks. If you don't have one, a spreadsheet is SUPER helpful in seeing progress, assessing doses, and getting input. Ask questions, any thread, any time.

4) Or shouldn't I switch at all and see how it goes in the month or so after the operation?

If you're still seeing regulation issues 3 weeks after the dental (depending on how complex the surgery is, and how well recovery goes), I would think about switching. Again-- dental + new insulin = hard to tell what caused what.

Hope that helps a little! Good luck with it, let us know how it all goes.

 

[Pat+Raja+Shadow (GA)]

We were on Vetsulin (both my litter mate kitties dx on Aug 5th) and I found it pretty difficult to regulate Shadow
on that type of insulin. He needed something that would stay with him past 6 hours....

Raja had lower numbers to begin with and she did much better on it....we switched to Levemir 6 weeks later. Shadow had a dental
on Aug 31st. If you glance at his spreadsheet, you will see much higher numbers than what you are seeing.... I am a big fan of the longer duration insulins Lantus and Levemir but in your case, I am inclined to agree with Greg....the dental might take care of infections that might be elevating the numbers....Dentals change BGs after a short time for the better in most cases....

On the other hand, I am fairly new here and am not an expert in anything at all so I would suggest you wait for other opinions too... :mrgreen:

Can you say what you are feeding and also what kind of meter you are using at the moment?

 

[Lydia--(Rosie & Basil) GA]

Hi Ella,

Welcome to this group. They are, from what I can tell, some sort of miracle workers! I hope Spacey feels better after the dental. Love the name, BTW. Is that after Kevin Spacey?

 

[Roni and Moonie]

Welcome--You are in the right place--Any infection in the body can cause BGs to be elevated-I would wait till after dental & then switch. You have gotten some great answers here..We all help each other & someone is always here to help you 24/7-.

 

[Sienne and Gabby (GA)]

1) When is the right time to switch to another type of insulin? Before or after her tooth is removed (Jan, 13th)?

I agree with Greg and the others -- it will be hard to know if your current insulin is doing the job unless you can compare results after the dental work is done. Vet's often can't predict the extent of what needs to be done prior to a dental procedure. So, there may be more inflammation than your vet can see without Spacey being under anesthesia. I would wait until after the dental is done and Spacey is back to normal before making the switch to Lantus.

2) Do I have to pick a time when I'm able to home test a lot? (I work 4 day's a week, but I have a week vacation after Spacey's operation on her tooth f.i.

I think this is entirely up to you. It takes several days for Lantus to build up in a cat's system and achieve the necessary blood level (aka "shed") in order to become effective. This usually takes 3 - 5 (or more) days.

3) How should I prepare? What to read besides the Lantus board??

Definitely read the permanent notes (stickys) at the top of the board. Greg referred to the Tilly (German Tight Regulation) Protocol. We follow a modified version of this dosing protocol. One of our dosing experts also put together a shortened version in the form of general dosing guidelines.

The most difficult aspect of transitioning from a medium-acting insulin to a long acting insulin like Lantus is that you will need to think very differently about how these two insulins work. Rather than basing dosing on pre-shot (PS) levels, dosing is based on the nadir. Thus, it is critical to not just get PS test, it's also important to get spot checks throughout both the AM and PM cycles. The good news is that it already looks like you're doing this. We also do not consider a BG of 70 all that low and start feeding HC at that point. You'll note in the dosing protocols, a newly diagnosed cat like Spacey has to have a BG of less than 50 in order to earn a dose reduction. This approach will be very different. If for no other reason, I would agree with Greg that reading posts (condos) and spreadsheets will be great preparation if you do decide to switch and will be a good way for you to continue to raise questions.

 

[Spacey & Ella]

Hi Ella,

Welcome to this group. They are, from what I can tell, some sort of miracle workers! I hope Spacey feels better after the dental. Love the name, BTW. Is that after Kevin Spacey?

No, not Kevin Spacey.
Her name has to do with my wild day's.
Her brothers name = Stickey (or Sticky or joint [marihuana])
And hers come's from Spacecake (also Marihuana)
Dutch kids... :lol:

 

[Pat+Raja+Shadow (GA)]

Her name has to do with my wild day's.
Her brothers name = Stickey (or Sticky or joint [marihuana])
And hers come's from Spacecake (also Marihuana)
Dutch kids... :lol:

You are soooo funny.... :lol:
:lol: DH has a friend who got the name Space years ago....ok...you get an A+ for honestly....soooo funny!!!! :lol:

 

[Spacey & Ella]

Thanks to you all for the all the info.
I'm going to read till my head 's spinning.

To answer a few questions:
- Spacey is on wet food only since Christmas. And because of this, so is Chewie (her son). So now and then (I try on a daily basis) they get raw meat to chew on and to prevent huge drops in the bg-levels.
- I use the GlucoCard X-meter as my main meter. I've also bought the Precision Xceed to do some regular Ketone blood testings.

Btw: The vet taught me to adjust the dose according to preshots and the internist according to nadir.
Here they tell me to base the dose on multiple numbers. So, I'm testing all.
My cat has more piercings in her ear than I have. :lol:

Okay then, I'll keep her on the caninsulin and keep an eye on her after her dental.
In the meanwhile, I'm going to read read read...
Thanks again for all the info